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Friday, September 20, 2013

the chill of the fall

yepperz, it's darn right chilly here today!   a whoppin' 61 degrees here on the eastern high plains of new mexico...at it's 1:18pm...this is not normal...

what's a gal to do while it's drizzlin' outside (thank the stars fer more moisture, although many parts of the state are underwater, i'm so glad to see the light at the end of the tunnel - aka drought)?   why, make pizza of course!

not jest any pizza, coz i can't do gluten.  so, i went scrummagin' around and found a recipe to use up my cauliflower.  found a recipe at http://realsustenance.com/revamped-better-than-ever-cauliflower-pizza-crust-graingluteneggdairysoy-free/, but didn't want a huge pizza so cut the recipe in half.  great schtuff at ms brittany's place.  what to do fer toppings?  hmmm, can't do pizza sauce (maters are now huge no-no's and the gut doesn't lie), so figured i'd fry up some lean ground turkey breast with a concoction of seasonin' and toss on some shredded hard cheeses (thanks, crohn's, i miss gooey cheeses...)

anyhow, it's divine and the house smells almost as good as the other day when i was grindin' up homegrown herbs.  i shall dearly miss the smells of summer.

the hubs has been busy outdoors, although not necessarily tendin' to things that should be tended with winter approachin'.  especially since the farmers almanac says we're in fer a wet, cold winter.  i'd build a fire right this very minute if only i had some dry wood!  he's forgiven fer the moment though as he's turned some schtuff most folks haul to the dump into my vision.

my mom had given this set of outdoor patio furniture over 15 years ago.  14 years ago, it literally got the crap beat outta it by hailstones rangin' from ping-pong sized to grapefruit.  the frames of the table 'n chairs didn't even dent and they've jest been sittin' around.  much discussion on whether to tile the top of the table.  decided against it as the weight would've been horrific.  bungee cords came to mind - ya know, nice 'n comfy with a lil spring?  jest wasn't us.

mom had her fence in town replaced and she was kind enough to let us have the old, 1973 cedar fence. many projects came to mind as to what to do with all this lovely, naturally aged cedar and this won out. 3 more chairs to go and the table and we'll be set :D

Monday, September 9, 2013

why i believe "Obamacare" is NOT the fix fer our medical woes

on september 12, 2012, the hubs took me to the emergency room.  i was in bad shape.  i was numb from the middle of my head all the way down to the bottoms of my feet.  complete with extreme skin sensitivity, anythin' touchin' my skin anywhere on my body was agonizin'.  it felt like i had giant worms swimmin' in my head.  the left side of my face was in spasms.  i couldn't walk, it was as if my legs muscles were too weak and the left leg wouldn't go where i asked it.  a boa constrictor had taken up residence at the bottom of my rib cage.  an anvil rest on my lower back.  muscle spasms shook most of my body.  i had bloody diarrhea whenever i could actually keep anythin' down long enough fer it to get to my gut.

he thought i was dyin', and to be completely honest, so did i.  i wasn't frightened by it though.  seemed like a good solution to the complete and utter hell my body and mind had been goin' through.  i couldn't focus, i couldn't think straight, couldn't walk, couldn't hold onto even a small plastic cup. i'd quit sweatin', body hair quit growin', hair & eyelashes were fallin' out.  had no heat tolerance, yet if my extremities got cold, it intensified the hornets stingin' to an almost unbearable stage.   yepperz, i jest figured that was the end of me.

upon arrival, the triage nurse was mortified by my condition and rushed me back.  they were told of all my symptoms, all the cipro/steroids i'd been on and that my primary doc had given me a prescription for gabapentin fer the peripheral neuropathy and my experience with 'em.  a nurse practitioner came in and told me, "mrs. cook, i think yer havin' a heart attack".  i told her that i wasn't.  i told her it was all stemmin' from my gut. my blood pressure, heart rate and other vitals were within my norm, although elevated due to all the pain.  i've no history of heart  disease.  unconvinced, they insisted on doin' a full cardiac blood panel and an EKG.   well, surprise!  no heart attack.  they did start an iv, jest in case the blood work came back funky.

the previous paragraph took an hour fer her to return to my room to tell me my heart was fine.  after another hour of sittin' in the room, a nurse came in and told me to take some aspirin.  the hubs reiterated that i have crohn's disease, have been havin' bloody diarrhea, so the answer would be NO.
after another hour and an empty iv bag, the hubs went huntin' someone - he didn't care who.

another hour and a half went by with no monitorin', no meds fer the spasms, no nurse/nurse practitioner/e.d. doc comin' in.  2 hours later an xray tech came in.  hauled me down and did a chest xray and a CT scan of my head.  really?  what sort of info would one obtain while someone is havin' muscle spasms in the chest & head?   the tech said, "the e.d. doc will have the results from the radiologist within 45 minutes", then hauled me back to my room.

at hour 7, still with no nurse or nurse practitioner or e.d. doc, i was hauled back down to the xray dept - now they wanted a CT scan of my chest.  iv bag still empty, but at least he didn't have to struggle to get another vein to inject me with poison.  i asked him the point of all this with the spasms.  he replied, "ma'am, i'm jest doin' as was ordered."  i was so weak, the brain all muddled and in so much pain that i couldn't even argue.

8 hours and 27 minutes from the time i was taken back into the emergency room, the e.d. doc finally made her grand appearance.  told me i had peripheral neuropathy, wrote me yet another prescription fer gabapentin and told me to follow-up with a neurologist cuz there were "spots" in my brain scan.  they sent me home.  still broken, still no answers, they never did any testin' to see if it was my gut.  the e.d. doc didn't physically examine me, nor did the nurse practitioner.

the charge fer this "wonderful care" that was provided to me?  the hospital charged me $12,080.37.  the e.d. doc's bill was $894.00.  the radiologist (an innocent bystander 250 miles away) bill was $387.00.  wanna know why?  here's what the hospital administrator told me, "you were in the e.d. department for 8 and a half hours, mrs. cook."  me, "yes, i'm fully aware of that fact, sir.  if ya recall, i was there."  apparently they "charge by the hour".  i woulda had a smaller bill if i'd had a severed limb....  the e.d. doc's billin' department also informed me they charge by the hour.  i asked how this is possible from both entities, since i was basically left sittin' in a room fer the largest portion of that time and scans 'n xrays were done with full knowledge that my body was spasmin' and tickin' all over.  they jest told me that's how it's done.  end of story, i discussed this at great lengths with every supervisor, administrator, his boss, both billin' departments to no avail.

to make matters worse, the neurologist wouldn't see me without me payin' 'em $500 up front, since i had no health insurance.  needless to say, i didn't see the neurologist coz we jest don't have that sorta cash lyin' around, ya know?

fast forward to this present year, 2013.  after finally havin' to go all the way down to scott & white in temple, tx (487 miles one way) to get anyone to even listen to me that i was jest not doin' well, guess what?  severe crohn's, severe malnutrition, peripheral neuropathy "unknown etiology".  my great gastro there hooked me up with a gastro in lubbock, tx since it was decided i needed to be started on remicade asap and it was jest too spendy to drive back 'n forth to temple.  (by the way, i finally got approved fer health insurance november 2012 - high risk pool through my state)

my 1st 3 remicade infusions were given at the infectious disease control center in lubbock, tx.  simply adored my nurse.  all were polite, kind and understandin'.  the place was under "covenant medical services", in may it was bought out by "covenant health systems".  why is this important?  beats the heck outta me.  but apparently, it gives 'em the right to jack their services from $6212 an infusion to $24,109.82 fer the same exact infusion (ok, that's givin' 'em some leadway, cuz the last infusion i had to endure the pain of havin' 20mg of steroid shot directly into my vein - nurse said "the hospital says it costs too much to dilute it in some i.v. solution like we were doin").  same nurse, same facility, same nurse practitioner.

i called my insurance company, who paid their approved amount of $18,000 somethin'.  they didn't see the trouble.  said it was billed correctly and paid accordingly.  really?  am i the only person who sees somethin' snaky goin' on?  i discussed it with my gastro, he too was ticked off about it.  i'm not his only patient that gets treatment there and he'd already heard about their enormous jump in fees.  said he was lookin' into it.  i filed an appeal with my insurance company in order to get the higher ups involved in this injustice.  i called the billin' department and requested a complete itemization along with ICD9 codes to all the procedures, meds 'n labs fer all my visits.  i called the infusion center, who told me to call billin' back.  there are no folks to answer the phone, so i left a voice mail.  the next day (almost a complete 24hrs), this gal called me back and informed me that they had every right to bill it as an "outpatient procedure" instead of the prior "doctors office procedure".  she didn't understand my trouble with it, told me to call the fella at the infusion center.  i spoke with him, got the same explanation (amazin' how it's identical with the insurance co/facility billin'/infusion center, they must have the speech written down...).  i told him it jest wasn't right.  he told me, "i agree, it's not morally right" and gave me 2 numbers to his supervisors.  guess what?  they "are away from their desk", per the voice mail messages.  i left 'em both a message.

folks have been gettin' their chemo from this facility as well.  their bills skyrocketed also.  i do not understand how this can be allowed.  i'm outraged.  i've sent an email to the president, and every elected official in both states.  i also sent one to the states attorney generals office.

the hubs says, "jest leave it alone, hun."   how can i?  even as a "private pay" patient, i never received an itemized bill.  i got a bill that said "lab services", "supplies", etc.  no detail as to what the charges were actually fer.  i received what i consider to be "non care" from the emergency room.  all the folks listed from november 2012 have turned me over to collection agencies.  coz i didn't pay my bills in full within 6 months.  how could i?  it's not like i've been able to find employment since i can no longer safely drive, can't walk half the time, can't hold a pen at times, my speech still changes, brain fog, muscle tic's and there's even times when i jest can't type as it feels like my fingernails will explode off my fingers with every stroke of a key.

yepperz, i'm disgusted and "Obamacare" will do not a useful thing to stop the immoral practices of the medical profession.....

Friday, September 6, 2013

the "rights" of medical facilities/providers versus the "rights" of patients

i know, i should prolly start off by apologizin' fer a long stretch of no posts.  i do apologize, but one must understand that my health has gone down the crapper in the past year.  from somethin' jest aint right to holy crap....

anyhow, i've learned many things durin' this downhill slide - 1) some doc's will not and do not "think outside the box".  if they don't know what's wrong with ya, they right'cha off as a hypochondriac.  2) they will not try to get'cha the help that'cha need.  why?  coz they think yer nuts.  3) once ya find the "right" doc's on yer own, they will do their best to get'cha well within their realm...then they jest leave ya hangin' and most won't assist ya while ya try to get yer body straightened out.  yepperz, yer on yer own to pursue whatever care ya feel ya need.  even if ya don't know what that is - the burden of that responsibility falls on yer shoulders. 4) they can charge whatever the heck they want.  why?  because they can.  if ya have insurance (ya better have this coz they'll really put the screws to ya if ya don't), they will back up this provider on the ridiculous amounts that are charged.  i mean, hey, they've already argued and negotiated prices in order to be "participatin' providers".  supposedly to "everyone's advantage".

which brings me to my point.  i was finally diagnosed proper down at scott & white in temple, tx fer one of my health hiccups.  yepperz, the hubs hauled me back 'n forth that 487 miles one way from our home many times between november 2012 and february 2013.  great bunch of folks their.  some greater that others.  they will test ya to death in order to find answers....well, some of 'em do.  others exhaust their knowledge and afterwards ya end up with "unknown etiology" as yer diagnosis.  which leaves ya with more questions than answers and ya have to muster up the strength to pursue it's investigation on yer own, more to that later.....

my "gripe" today, and boy do i have a big'un, is the unfair billin' practices that some places seem to be privy to.  i swear, they are right up there with politicians in regards to their practices!  today i've found there's not much to be done about it, so i am hopefully bringin' it to "the masses" in a prolly futile attempt to get more folks to pitch a fit.  why?  because it jest aint right and i know that i'm not alone in this "bein' screwed with a kiss".  some say "jest leave it alone, yer into 100% coverage and yer insurance paid it all".  well, does that make it right?  where does this fundin' come from anyhow?  ever wonder why yer insurance costs so darned much?  this is why, folks!  luckily (there's a pun there...), the only insurance company that would cover me is our states "high risk pool", which costs a fortune.

i had to undergo remicade iv infusions, til they made me break out in eczema anyhow.  (which the 1st derm denied - 3 doc's later and 2 biopsies confirmed)  i have severe crohn's throughout my entire large colon, spare the ileum.  i don't have many "choices" in treatments.  i have peripheral neuropathy from my first batch of doc's (another long story there to be shared another time), and now this eczema - which has "grown" from blisters/rash on the hands 'n feet in may to 80% of my entire body.  that leaves me as a "undesirable participant" fer anymore biological drugs to put the crohn's into remission...

what's got my panties in a huge wad is that when i began my infusions, they cost $6100.00 each.  the facility where i received these treatments was bought out my the big hospital in that town (i traveled 221 miles round trip fer these darned things as i live in a small town).  no problem, same exact staff.  i got this same identical treatment initially, at 2 weeks, then 4 weeks, then 8 weeks.  the 1st three visits were all billed the same - $6100.00.  the last visit fer the same (minus the diluted steroids, as the nurse said the hospital told 'em it was "too expensive to dilute the steroids, so it was jest shot directly into my vein - can ya say HOLY CRAP THAT HURTS?) except fer the billin'.  sit down folks coz this is gonna shock ya - or at least it should.  $24,109.62!!!  yepperz, that's what they billed AND INSURANCE PAID IT!

i called the facility, whom put me in touch with the billin' department.  who told me they had every right to bill it that way.  i contacted my insurance company and they investigated it.  jest got off the phone with 'em and they said, and i quote, "the 1st 3 visits were billed as office injections, the last 1 was billed as done at an outpatient facility".  WTH!  i explained, in great detail that it was the SAME facility, the SAME nurse, the SAME nurse practioner, the SAME treatment outside of the fact they'd gone cheap and no longer diluted the steroids and jest shot it straight into my vein.  i asked this young lady from the insurance company how this could happen.  i told her i understood the way insurance companies negotiate pricin' and such, i worked at our local hospital fer 16yrs and dealt with insurance companies daily.

i'm not an idiot.  i know the games that are played.  but to me, this is wrong on so many levels.  i filed an appeal.  i do NOT feel this should be legal.  i will hunt down whomever i need to in an attempt to get this rectified.  again, most folks would and have said, "what does it matter?  yer not out anythin'..."

i've also requested itemized, in detail, from the billin' department at the hospital.  i've never received anythin' from 'em.  i don't understand how we, as patients, have to fight to get our records (another lengthy story, if someone reminds me, i'll tell that wicked tell).  why do we also have to fight to get an itemized statement?  i didn't get a thing from 'em.  other places i get vague ones such as "laboratory services" - really?  what labs?  i want and deserve details, as does every single patient out there - regardless of who's footin' the bill.  how else do we know when charges are incorrect?

why do folks tend to turn a blind eye if they don't have to pay fer it?  SOMEBODY has to pay fer it.
 be it in higher premiums or jest goin' without the proper healthcare (as i did fer many years coz i had no insurance, hubs kept sayin' we couldn't afford it), it's WRONG.  more folks need to smack these overpriced providers.  to hades with "obamacare" - fix what's not right with the medical profession.... we as "consumers" (in case ya didn't get that memo, that's what we, as patients, are these days) have the responsibility to be the "check 'n balance" as it appears that nobody else seems to give a darn.